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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371704
Report Date: 12/17/2024
Date Signed: 12/17/2024 11:34:27 AM

Document Has Been Signed on 12/17/2024 11:34 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:GIVINGTREE MONTESSORIFACILITY NUMBER:
304371704
ADMINISTRATOR/
DIRECTOR:		SOOYOUNG SHINFACILITY TYPE:
860
ADDRESS:1901 NORTH EUCLID STREETTELEPHONE:
(714) 336-2872
CITY:FULLERTONSTATE: CAZIP CODE:
92835
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 0DATE:
12/17/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Sooyoung Shin, Applicant/Director TIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On December 17, 2024 at 8:45am, Licensing Program Analyst (LPA), (P Rivas) conducted an announced Pre-Licensing inspection for a change of location and met with Ms. Sooyoung Shin, Applicant/Director , Jin Hong, Staff/translator, Seong Son, CEO. Applicant is requesting to be licensed for 50 preschool children ages 2 to 6 years old in Rooms 1, 2, 3, 4 and 5 Hours of operation will be Monday through Friday 8:00am to 6:00pm.

All indoor and outdoor activity space utilized for the children was inspected today. LPA informed Ms. Shin & Son that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. A fully equipped first aid kit is located in front lobby. There is an operational carbon monoxide detector on site located in room 2. All required licensing documents were observed posted in the front entrance. Children will be signed in and out at front entrance.

LPA continued to tour the facility and measured all indoor and outdoor activity space. Total indoor activity space measured at 1751.04 Square feet, which is sufficient to accommodate the requested overall capacity of 50 Children. LPA viewed age-appropriate furniture and equipment, including tables, chairs, cubbies,
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE: DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GIVINGTREE MONTESSORI
FACILITY NUMBER: 304371704
VISIT DATE: 12/17/2024
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napping cots/mats, bookshelves, and other activity supplies for the children. Drinking water is available in the classrooms via children's own water bottles and will be refilled from the kitchen sink which has a filtering system in place. LPA observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property. Fire clearance was granted for 50 children ages 2 to 6 years old in rooms 1,2,3,4 & 5 on 09/18/24. .

LPA observed a total of 4 sinks and 4 toilets available for children’s use. LPA also viewed one potty chair. There is a staff bathroom that includes one toilet and one sink. There is a sink in the kitchen. These are sufficient to accommodate the requested overall capacity of 50 children. The isolation area for children who are ill will be the in room room 3 near the staff bathroom.



Facility will provide an am snack, lunch and a pm snack. The kitchen area currently includes microwave, pressure cooker, sink. The kitchen area and food storage areas were observed to be free of rodents and/or vermin. Food was observed to be properly stored separate from cleaning materials. Hazardous items in kitchen are inaccessible to children via a locked door.

The facility currently has a fully fenced playground area.Fencing is wood and concrete and is at least four feet high. The total square footage for all the outdoor activity space for the preschool is 13010.06 square feet, which is sufficient to accommodate the requested capacity. Shade is provided via overhangs, two canopies, and an umbrella. There are sufficient outdoor
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GIVINGTREE MONTESSORI
FACILITY NUMBER: 304371704
VISIT DATE: 12/17/2024
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age-appropriate toys and play equipment available on the playground(s). There is a climbing structure on the preschool playground(north west) for children ages 2 to 6 years old per applicant. Drinking water is available via children's own water bottles which can be refilled in the kitchen using filtered system. LPA observed all hazardous items on the playground(s) to be inaccessible to children. Applicant Ms. Shin was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).



Ms Shin, applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GIVINGTREE MONTESSORI
FACILITY NUMBER: 304371704
VISIT DATE: 12/17/2024
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includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA reviewed with applicant, Ms Shin the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Ms. Shin was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.




The following corrections are needed prior to the issuance of the license:
1. Provide manufacturers information regarding adequate cushioning in fall zones as the playground is synthetic grass
2. Applicant reports she will add an auditory device to North West exit out of playground (which leads into the trees.) Applicant advised that teachers will be posted near that exit as it has an automatic egress and will train staff to always have direct supervision of children. Picture of auditory devise can be sent to LPA for verification.

3. Consultation with Regional Office

4. Final file review.

Applicant/Licensee Representative Ms. Shin understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied.

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024
LIC809 (FAS) - (06/04)
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